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目的研究杭州地区乙型肝炎患者乙型肝炎病毒(HBV)基因型分布、P区耐药突变基因状况及两者的相关性。方法利用荧光定量PCR和DNA测序技术,对慢性乙型肝炎患者的血清标本进行HBV基因型及P区耐药突变位点检测。结果 217例慢性乙型肝炎患者中检出HBV基因B型59例,C型127例,D型2例,B+C混合型6例,B+D混合型1例。对拉米夫定、阿德福韦、恩替卡韦和替比夫定耐药数分别是39例、18例、25例和71例。突变基因以M204I、L180M和M204V最多。YMDD突变类型在B、C基因型中的分布差异无统计学意义(P>0.05),而YMDD中的M204I、M204V发生在B、C基因型中的差异有统计学意义(P<0.05)。结论杭州地区HBV基因型以B型和C型为主,HBV耐药突变以M204I、L180M和M204V多见。应根据基因分型和耐药突变情况对慢性乙型肝炎患者选择适合的治疗方案。
Objective To study the distribution of hepatitis B virus (HBV) genotypes in Hepatitis B patients in Hangzhou area and the relationship between the mutations of drug resistance mutations in P region and the two. Methods Fluorescent quantitative PCR and DNA sequencing were used to detect the HBV genotypes and the drug resistance mutation sites in the serum of patients with chronic hepatitis B. Results Among 217 patients with chronic hepatitis B, 59 were HBV genotype B, 127 were C, 2 were D, 6 were B + C and 1 was B + D. Resistance to lamivudine, adefovir, entecavir and telbivudine was 39, 18, 25 and 71, respectively. Mutant gene to M204I, L180M and M204V up. The distribution of YMDD mutation genotypes in B and C genotypes was not statistically significant (P> 0.05), while the M204I and M204V YMDD genotypes in B and C genotype differences were statistically significant (P <0.05). Conclusion The genotypes of HBV in Hangzhou are mainly B and C. HBV resistance mutation is more common in M204I, L180M and M204V. Should be based on genotyping and drug resistance mutations in patients with chronic hepatitis B choose the appropriate treatment.